Title reigns are determined either by professional wrestling matches between different wrestlers involved in pre-existing scripted feuds, plots, and storylines, or by scripted circumstances. Wrestlers were portrayed as either villains or heroes as they followed a series of tension-building events, which culminated in a wrestling match or series of matches for the championship. Reigns that were won on pay-per-view events aired on tape delay up to weeks or months apart. Reigns that were won at live events were released on DVD. Title changes that occurred on ROH's primary television program, Ring of Honor Wrestling, air up to three to five weeks apart.

The inaugural champions were The Prophecy (Daniels and Morgan), whom ROH recognized to have become the champions after defeating American Dragon and Michael Modest on September 21, 2002 at ROH's Unscripted event in the finals of a one-night tournament.